Healthcare Provider Details

I. General information

NPI: 1427300904
Provider Name (Legal Business Name): VIRGIN ISLANDS HEART LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2012
Last Update Date: 10/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 ESTATE THOMAS SUITE 203
ST THOMAS VI
00802-2611
US

IV. Provider business mailing address

PO BOX 8508
ST THOMAS VI
00801-1508
US

V. Phone/Fax

Practice location:
  • Phone: 340-714-3278
  • Fax: 340-714-3279
Mailing address:
  • Phone: 340-714-3278
  • Fax: 340-714-3279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1260
License Number StateVI

VIII. Authorized Official

Name: DR. ROY D FLOOD JR.
Title or Position: CEO
Credential: M.D.
Phone: 340-714-3278